Research on management issues in the pharmaceutical industry: a literature review

The Impact of Two-Invoice System on Pharmaceutical Manufacturers' Selling Expenses in China: A Difference-in-Differences Approach

A perennial question for the pharmaceutical industry has been excessive drug prices. To alleviate patients’ burden of expensive medical bills and increase the affordability of medicines, China adopted the Two-Invoice System (TIS) in drug procurement for public medical institutions in 2017. In this paper, we study the impact of the TIS on pharmaceutical manufacturers’ selling expenses. Using a Difference-in-Differences (DID) methodology and a sample of the A-share pharmaceutical manufacturing firms listed on the Shanghai Stock Exchange and Shenzhen Stock Exchange from the years 2014 to 2020, we find that the TIS leads to a significant increase in pharmaceutical manufacturers’ selling expenses but gradually weakens over time. In addition, we further explore whether the impact of the TIS on pharmaceutical manufacturers’ selling expenses is affected by the pharmaceutical manufacturers’ previous drug circulation mode. The results indicate that the TIS could significantly increase the pharmaceutical manufacturers’ selling expenses in the agency mode group. However, there is no evidence to support the TIS having the same effect in the direct sales office model group.

Critical Success Factors and Traceability Technologies for Establishing a Safe Pharmaceutical Supply Chain

Drug counterfeits have been an international issue for almost two decades, and the latest statistics show that fake medications will continue to penetrate legitimate pharmaceutical supply chains (PSCs). Therefore, identifying the issues faced by PSCs is essential to combat the counterfeit drug problem, which will require the implementation of technologies in various phases of the PSC to gain better visibility. In this regard, a literature review was conducted to fulfill the following objectives: (i) review the application of traceability technologies in various PSC phases to detect counterfeits; (ii) analyze the various barriers affecting the establishment of a safe PSC and the critical success factors used to overcome those barriers; and (iii) develop a conceptual framework and guidelines to demonstrate the influence of traceability technologies and success factors on overcoming the various barriers in different phases of the PSC. The major finding of this review was that traceability technologies and the critical success factors have a significant influence on overcoming the barriers to establishing a safe PSC.

Antecedents and outcomes of patient satisfaction in healthcare: A conceptual model

This study develops a conceptual model and establishes the relationships between the variables, both influencing and affected by patient satisfaction. The authors conducted a thorough search for peer-reviewed articles obtaining a final sample of 64 studies. Service quality was found to be the only antecedent influencing patient satisfaction, while patient satisfaction was found to impact trust, loyalty and word of mouth, also mediating the influence of service quality on these variables. While the study integrates the scattered literature, from a practical standpoint it exhibits how increased patient satisfaction plays a key role in influencing patient trust, loyalty and word-of-mouth.

Opportunities and challenges for contactless healthcare services in the post-COVID-19 Era

This study examines the opportunities and challenges involved with contactless healthcare services in the post-COVID-19 pandemic era. First, we reviewed the literature to analyze contactless or contact-free healthcare services that have been utilized in pre-and during the COVID-19 pandemic periods. Then, we interviewed medical experts and hospital administrators to gain knowledge about how healthcare providers are currently working to mitigate the spread of COVID and preparing for the post-pandemic period. Thus, we analyzed the evolution and utilization of contactless services during the three different time periods: pre-, during-, and post-COVID-19. The results indicated that in the post-COVID-19 era, a new normal of hybrid healthcare services would emerge. While some of the contactless services that have been practiced during the pandemic may revert to the traditional face-to-face services, those innovative contactless healthcare services that have been proven effective during the pandemic would be practiced or even advanced in the post-pandemic period due to the accelerating technological developments. This study suggests many potential opportunities and daunting challenges for healthcare institutions, policymakers, and consumers regarding the implementation of contactless services in the post-COVID-19 era.

Key determinants of quality in the pharmaceutical supply chain

Purpose

Empirical studies on the supply chain quality management (SCQM) of the pharmaceutical sector are scarce and scattered. This paper investigates a set of key quality determinants in the pharmaceutical sector to offer a holistic quality control framework for its supply chain (SC).

Design/methodology/approach

A mixed-method design was used. A focused group discussion with seven pharmaceutical SC managers summarized the narratives of the SCQM in this sector and helped to develop a questionnaire. The survey data were collected from the managers of 299 pharmaceutical firms.

Findings

The statistical results show the key determinants are leadership (LS), customer focus (CF), process integration and management (PIM), supplier relations (SR), quality practice (QP), human resource practices (HRP) and safety (SF). Unlike many other sectors, in the pharmaceutical SC, logistics and inventory costs have been proved to be not as important as other measures in the eyes of the SC managers and as part of SCQM performance measures, which can be a result of the priority systems influenced by the World Health Organization standards.

Originality/value

The study is distinctive in its scope as is carried out in a developing country with focus on concept of SCQM with reference to pharmaceutical SC. It shows great potential for further studies and improvements in logistics and warehousing in this sector, for the interest of the pharmaceutical SC managers and regulators who aim to ensure safety and quality in the health-care sector.

The Impact of Cultural Intelligence on Organisational Performance: Applied Study in Sample of Jordanian Pharmaceutical Companies

The aim of this study is to determine the impact of cultural intelligence in its four dimensions (metacognitive, cognitive, motivational and behavioural) on organisational performance based on three criteria: productivity, profitability and market share in Jordanian pharmaceutical companies. The study is sought to provide a broad review of the literature of cultural intelligence and administrative practices in the field of business administration and research in different parts. The results of the study confirmed that there is an impact of three dimensions of cultural intelligence (metacognitive, cognitive, behavioural) on organisational performance (productivity, profitability, market share), while the motivational dimension has no impact on all three performance criteria in Jordanian pharmaceutical companies.

Understanding ethical/unethical behavior in pharmaceutical companies: a literature review

Purpose

The purpose of this paper is to examine and review the available literature on ethical/unethical behaviour of pharmaceutical companies and to determine the ethical issues, unethical behaviour by analysing, summarising and categorising the factors related to these issues and unethical behaviour as were studied during the period 2008-2017. Essentially, this paper presents a critical analysis of the available literature on the subject and avenues for future research.

Design/methodology/approach

This paper adopted the systematic review approach to achieve the purpose of this study and examines the most relevant literature from online existing database sources, available between 2008-2017 by using the keyword search method. Then studies are categorised and summarised, using previously developed theories and frameworks, which have provided evidence to the universal consensus that ethical behavioural outcomes are dependent on the interplay of individual, organisational and environmental factors and have reordered to fulfil the purpose.

Findings

The findings identify that ethical issues related to pharmaceutical companies as were studied during the period 2008-2017 are drug pricing, drug safety and gift-giving. The organisational variables appeared to be the dominant cause of these ethical issues and unethical practices along with other determinants such as environmental and stakeholders. A large number of studies were in the western country context. Theoretical research has studied more comparatively empirical studies.

Research limitations/implications

This review provides insights for understanding the ethical issues, unethical behaviour and determinants related to these issues of pharmaceutical companies and provides insights where the literature is standing. This review only includes studies between 2008-2017, which are related to the ethical issue of pharmaceutical companies, therefore, the view is only of the past 10 years papers. This review provides gaps and insight into the source of ideas for future research and will help the researchers in guiding ethics-related information in the context of pharmaceutical companies.

Practical implications

This study will help the practitioners and policymakers in informing about the issues that required the urgent need to solve and will shed some light to focus and formulate strategies for successful competitive advantage. This study will help researchers who are seeking information related to ethics and ethical behaviour in pharmaceutical companies.

Originality/value

To the best of my knowledge, this review of understanding ethical/unethical behaviour in pharmaceutical companies of the past 10 years between 2008-2017 has not been done to date. This study is filling the gap by bringing all the information about ethics in pharmaceutical companies at one place, which works as an index of ethics-related study in this specific pharmaceutical company context.

Segmental differences in pharmaceutical industry and its impact on supply chain performance

Purpose

Pharmaceutical industry involves highly specialized business processes where strong research and development focus along with market differentiation and localization are the deciders of success. This has led to evolution of segments and complexities in supply chain. This paper aims to focus on segmental differences in supply chain performance of Indian Pharmaceutical firms.

Design/methodology/approach

This paper measures supply chain performance of select segmental players of the pharmaceutical industry using financial metrics and supply chain operations reference (SCOR) key performance indicators through a five-year timeline. The best performance results are compared across the segments to identify unique performance features, if any. The sample results are validated through hypothesis testing methodology.

Findings

This paper has evidenced that the innovators segment is performing better in cash-to-cash cycle time and supply chain working capital productivity, whereas generics segment is doing better in distribution cost efficiency and total cost to serve aspects.

Research limitations/implications

The paper is based on historical financial data of firms and measures the firm focused supply chain performance. The results may not be generalized in a global context but serve as a motivator for other researchers to take similar studies. The paper may further be analyzed with primary data of the firms to understand the segmental difference in customer focus supply chain performance measures.

Practical implications

This paper has brought out important segmental supply chain performance features of the Indian pharmaceutical firms and identified segment-specific problems by integrating SCOR KPIs and financial metrics.

Originality/value

This paper has integrated both SCOR KPIs and financial metrics to provide unique insights on segmental differences in the performance behavior of pharmaceutical supply chain.

A systematic literature review of healthcare supply chain and implications of future research

Purpose

This paper aims to review the healthcare supply chain (HSC) literature along various areas and to find out the gap in it.

Design/methodology/approach

In total, 143 research papers were reviewed during 1996-2017. A critical review was carried out in various dimensions such as research methodologies/data collection method (empirical, case study and literature review) and inquiry mode of research methodology (qualitative, quantitative and mixed), country-specific, targeted area, research aim and year of publication.

Findings

Supply chain (SC) operations, performance measurement, inventory management, lean and agile operation, and use of information technology were well studied and analyzed, however, employee and customer training, tracking and visibility of medicines, cold chain management, human resource practices, risk management and waste management are felt to be important areas but not much attention were made in this direction.

Research limitations/implications

Mainly drug and vaccine SC were considered in current study of HSC while SC along healthcare equipment and machine, hospitality and drug manufacturing related papers were excluded in this study.

Practical implications

This literature review has recognized and analyzed various issues relevant to HSC and shows the direction for future research to develop an efficient and effective HSC.

Originality/value

The insight of various aspects of HSC was explored in general for better and deeper understanding of it for designing of an efficient and competent HSC. The outcomes of the study may form a basis to decide direction of future research.

Understanding service quality: insights from the literature

Purpose

The purpose of this paper is to review the service quality (SQ) literature in order to understand issues involved in its conceptualization and operationalization.

Design/methodology/approach

The paper uses systematic literature review method. The unit of analysis is peer-reviewed journal articles published during 1984 to 2017.

Findings

Findings suggest manufacturing, banking, information technology, higher education, healthcare are the top sectors contributing to the SQ literature. More than 60 models of the SQ have been identified. Service-driven capabilities may be structured along adaptation with strategic drivers and imperatives, learning and alignment, and problem structuring. In doing so the SQ literature is evolving across overlapping phases of conceptualization, expansion, re-conceptualization and integration.

Research limitations/implications

The paper contributes to the body of knowledge by presenting a unified synthesis of more than 814 articles published in the last three decades.

Practical implications

Insights from the paper will help practitioners in understanding customers’ expectations and accordingly configuring effective service delivery systems, setting standards and communicating value to end-customers. This in turn helps them in developing service-based competencies and achievement of competitive advantage.

Social implications

Insights from the paper may help in conceptualizing and delivering SQ-driven public services.

Originality/value

The paper synthesizes and presents various facets of the SQ as a unified body of knowledge.

Strategic issues in pharmaceutical supply chains: a review

Purpose

In the present context of a health-concious society, management of pharmaceutical supply chains has become more complex because it involves the life-saving interest of human being and requires the participation of different stakeholders such as pharmaceutical manufacturers, wholesalers, distributors, customers, information service providers and regulatory agencies. Limited research is available in the area of pharmaceutical supply chains. This paper aims to find the gaps in the literature by reviewing research papers on different strategic issues of supply chain management in the pharmaceutical sector.

Design/methodology/approach

In total, 136 research papers, mainly from refereed international journals, were reviewed to identify the issues of supply chain management (SCM) in the pharmaceutical supply chain. On the basis of a review, gaps are identified and research agenda is proposed.

Findings

It is observed from review that the pharmaceutical sector is not widely researched in developing countries because of many complexities in this supply chain. The share of pharmaceutical firms in the global market is also not very significant. Based on an extensive review of pharmaceutical supply chains, research gaps are identified in different areas such as inventory management, new product development, process development, capacity planning, network design, plant design, pipeline and development management, outsourcing logistics activities, reverse logistics, Lean manufacturing, green SCM and implementation of E-business processes and performance management. These strategic issues have been further classified into three broad categories, i.e. resources, processes and performance.

Originality/value

This paper explores major strategic areas of pharmaceutical supply chains for research. Findings of the paper will be highly useful for researchers to decide direction of future research.

SR, B. R. Measuring service quality in pharmaceutical supply chain – distributor’s perspective

Purpose

The aim of this paper is to contribute to the services marketing literature by developing a scale based on Parasuraman’s SERVQUAL scale for the measurement of distributor perceived service quality at the distributor–manufacturer interface of the pharmaceutical supply chain.

Design/methodology/approach

Based on a literature review and discussions with experts, a questionnaire was designed basing on the widely used service quality measurement scale (SERVQUAL). Personal survey was conducted among selected distributors spread over three major cities of the Indian pharmaceutical market. The study used the exploratory factor analysis to identify the critical factors of service quality followed by the confirmatory factor analysis (AMOS 20).

Findings

A valid scale with four dimensions – (reliability, assurance, responsiveness and communication) and 13 items for measuring the distributor perceived service quality was developed which also satisfied all the reliability and validity tests. The findings of the present study indicate that distributor perceived service quality has an effect on satisfaction.

Practical implications

The proposed scale is an attempt to explore the less researched area. This study will give further insights to researchers to measure service quality at different phases of the pharmaceutical supply chain. The study is limited to three cities; it can be extended to other regions of the country. This study will be helpful to the practicing managers to measure the service quality and improve the performance in the pharmaceutical supply chain.

Social implications

Service quality in pharmaceutical supply chain is very important, as it directly effects the health of the people, so the proposed scale can be used to control the quality of service.

Originality/value

The scale developed in this study can also be used for measuring distributor perceived service quality in other manufacturing sectors. This research provides direction and scope for further research to develop new concepts and models in measuring service quality in the supply chain.

“Infecting” those we care about: social network effects on body image

Purpose

This paper aims to explore the forces at work that negatively influence the self-image perceptions of young women, causing them to strive for an “ultra-thin” ideal.

Design/methodology/approach

Focus groups explore why and how perceived self-image influences young women’s body and perceptions and, consequently, health. Thematic qualitative analysis explores the realm of information and emotions involved with the thin-ideal.

Findings

Social contagion theory emerged with a significant impact caused by network influencers and the spread of information and emotions within social networks forces that sustain the need to be ultra-thin, even though there is abundant knowledge about adverse effects.

Research limitations/implications

Future research should address limitations involving representativeness and generalizability.

Practical implications

Social marketing programs, including social media, should stress healthy eating habits while focusing on the importance of the self and de-emphasizing the “thin-ideal” image.

Originality/value

Results will assist in developing more informed and effective prevention programs, including social media campaigns, as preventative healthcare to reduce the risk of the spread of eating disorders and promote psychological health of at-risk young adults.

Communication drivers for drug adoption in an uncertain world

Purpose

The quality and reliability of medical communication for branded drug adoption is extremely critical, not only for safeguarding patient interests but also for ensuring successful investments by multinational pharmaceutical firms. This paper predicts doctors’ prescribing intentions based on communication relationship among factors for late entrant branded drugs, compared with pioneering brand choice, for treating chronic diseases such as hypertension.

Design/methodology/approach

The constructs were validated with structural equation model for a sample set of 151 doctors from private hospitals in the National Capital Region of India.

Findings

This research reveals communication drivers and draws on theory to suggest that the doctor’s behavioural prescription intentions, subject to social influence from their colleagues, leads to lower adoption responses.

Research limitations/implications

Given that limitations on sample size are often unavoidable, this study reveals that, due to the availability of substituting brands, alternate therapeutic routes and lack of availability of a practical guide for prescription, a communication model needs to be developed and validated.

Practical implications

Furthermore, managers of pharmaceutical firms should differentiate between the effects of direct and indirect communication–integration efforts for minimizing uncertainty in drug adoption in the context of the fragmented and unpredictable Indian market.

Originality/value

A late entrant may lose its dominant market share to alternate brands from other suppliers due to communication gaps in an unstructured market, leading to low adoption intentions. The study provides business theorists, drug marketers and health-care professionals with unique insights into specific communication drivers of prescribing decisions, aimed at ensuring reliable and appropriate drug adoption in Indian markets.

Do consumers perceive their doctors as influenced by pharmaceutical marketing communications?

Purpose

– This paper aims to explore whether and how consumers perceive the impact of pharmaceutical marketing on their own doctor’s prescribing behaviors, and subsequent responses toward their doctor’s advice.

Design/methodology/approach

– Three experimental studies were conducted. Studies 1 and 2 are based on text-based manipulations and undergraduate student research participants. Study 3 uses image-based manipulations and average adult consumers.

Findings

– Study 1 demonstrates that consumers can be quite skeptical about their doctor’s motives for prescribing certain brand-name drugs; in particular, consumers can construe doctors as agents of persuasion for prescribed brands. Study 2 shows that this can result not only in choosing generic drugs over prescribed brands but also in opting out of pharmaceuticals altogether by choosing alternatives like natural remedies. Study 3 further demonstrates that these effects can be easily triggered by visual cues in a non-student sample.

Originality/value

– This research builds on the existing literature on pharmaceutical marketing communications, and extends the theory of persuasion knowledge into healthcare settings.

Identifying and prioritizing industry-level competitiveness factors: evidence from pharmaceutical market

Background

Pharmaceutical industry is knowledge-intensive and highly globalized, in both developed and developing countries. On the other hand, if companies want to survive, they should be able to compete well in both domestic and international markets. The main purpose of this paper is therefore to develop and prioritize key factors affecting companies’ competitiveness in pharmaceutical industry. Based on an extensive literature review, a valid and reliable questionnaire was designed, which was later filled up by participants from the industry. To prioritize the key factors, we used the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS).

Results

The results revealed that human capital and macro-level policies were two key factors placed at the highest rank in respect of their effects on the competitiveness considering the industry-level in pharmaceutical area.

Conclusion

This study provides fundamental evidence for policymakers and managers in pharma context to enable them formulating better polices to be proactively competitive and responsive to the markets’ needs.